Latest Updates: Cases of the Week

This 30 year old patient from Fontana California was interested in breast augmentation revision. She felt that her right breast implant was bottoming out. She didn’t like the shape, size or placement of her breast implants.

This 41 year old homemaker from Riverside County (Winchester California) had breast augmentation surgery 12 years ago but now wanted breast revision surgery. She was very happy with Dr. Pousti’s expertise and so she discussed her goals with him.

This 55 year old patient was interested in revision breast surgery and was looking for the best plastic surgeon to help her achieve her goals. Breast augmentation revision experience is what she was looking for in a surgeon. She found Dr. Pousti and was very pleased with his expertise regarding revision breast surgery.

She was not happy with the size, shape and position of her current breast implants. Her breast implants fell outwards towards her armpits and she could feel the breast implant on the lower part of the right breast.

Markings and measurements are performed prior to surgery. The “arrows” show the areas where the patient was wanting more fullness. You can see the right breast implant falling off to the side as well as the thin skin on the lower pole of the right breast that will be addressed during the surgery.

This 32 year old patient fromSan Diego California was referred by a friend to Dr. Pousti. She was not happy with the size and/or placement of her breasts. She was looking for breast augmentation revision surgery as well as the internal bra.

After meeting and discussing her goals with Dr. Pousti, the patient felt very comfortable with Dr. Pousti’s expereince and decided to proceed with revision breast surgery.

Markings and measurements are performed and goals are discussed. The “red arrows” show where the patient is wanting more fullness. The internal bra will be performed for better breast implant placement on her chest wall.

This 35 year old had lost a lot of weight and was left with loose, hanging skin. He was interested in removing the excess skin and adipose tissue – male tummy tuck.

He searched for an experienced plastic surgeon to help him achieve his goals. He found Dr. Pousti.

After examination, he felt very comfortable with Dr. Pousti’s expertise and proceeded to book his surgery.

During the abdominoplasty surgery, the abdominal muscles are brought together (muscle plication seen above) and the excess skin is removed completely (seen in below photo).

Below shows the patient immediately after tummy tuck surgery. The loose, excess skin has been removed. The recovery for the tummy tuck can take months as the incision heals and the swelling subsides. The incision line will flatten out and lighten in color as things heal.

This 59 year old patient from had been thinking about brachioplasty surgery for 5+ years. She did not like the loose, hanging skin of her arms. She researched for a plastic surgeon with expereince performing arm lifting surgery. She found Dr. Pousti and was pleased with his expertise.

After meeting and discussing options, the patient decided to proceed with booking her surgery date. Dr. Pousti let her know that arm tissue relaxes with age, gravity and weight loss. The drooping of skin is from a stretching of the anchoring system of the arm and loss of supporting fat.

Brachioplasty (arm reduction surgery) can remove excess tissue and reduce the circumference of the upper arm. Surgical correction depends on the amount of extra skin and how loose the supporting tissues have become. Extra skin is removed from incisions along the inner arm. The incision must be placed where the tissue can be best tightened but the incision must be well hidden as well.

This 33 year old had been thinking about removing breast implants for several years. She was referred to Dr. Pousti by her family members and decided to come into the office for examinatin and discussion of options for her revision breast surgery.

After examination, it was determined that she would benefit from breast implant removal surgery as well as mastopexy surgery. The patient understood that her final breast size without breast implants could not be predicted prior to surgery.. many factors involved in that determination.

Above photo shows the patient prior to the start of surgery.Dr.Pousti performs markings and measurements that serve as a roadmap for the surgery

Above photos show the “Tailor Tacking Technique” used to confirm that enough skin (but not too much) will be removed during the procedure. Temporary staples are used along with the markings to visualize the final outcome prior to making an incision.

Above photos show the right breast implant removed and breast lift performed.. nice comparison to the left breast (not yet operated on).

This 37 year old patient from Israel had been thinking about revision breast augmentation procedure for 2 years. She was interested in the XL breast size. She wanted much larger, rounder implants with more fullness on top.

Markings and measurements are performed prior to surgery and the patients goals are discussed in more detail again.

Capsulorrhaphy surgery was also discussed with the patient for improved positioning of the breasts on her chest wall. This is also called the internal bra procedure. Dr. Pousti uses 2 layers of permanent sutures placed within the capsule that is around the breast implant to create a new pocket for the breast implant and therefore being able to improve positioning of the breast implants.

Dr. Pousti uses the incision at the junction of the breast and areola for the best access to perform the internal bra. Temporary sizers are placed to evaluate the size and position of the breasts during the procedure.

Below photo is of her silicone gel breast implants that were removed during surgery.

Above photos show the patient after removal of her silicone gel breast implants and replacement with Mentor 800cc over-filled Saline breast implants — 1500cc for both breasts.

She wanted her breasts larger, “lifted” and “more perky” . She researched for the best plastic surgeon to help her with her breast augmentation surgery and found Dr. Pousti. After examination, it was determined that breast implants as well as a full breast lift would be necessary to achieve her goals.

Breast augmentation / mastopexy surgery and the potential risks and complications were discussed with the patient in detail and the patient was taken into the operating room. The markings performed prior to surgery are used as a roadmap during the procedure.

Below photos show the “tailor tacking technique” in which temporary staples are used to confirm that the measurments and markings are accurate. Dr. Pousti wants to remove enough skin to “lift” the breasts but needs to be careful not to remove too much during the procedure.